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Policy and Politics

Accurate assessment of the impact of tobacco use on health outcomes and healthcare expenditures is critical in regulatory science to assist policy makers to promulgate rational policies. However, confounding is a potential problem for assessments based on observational studies. Recently, modern analytic methods that use causal modeling have been successfully applied to address confounding inherent in observational research.

Tobacco dependence continues to be the single most preventable cause of morbidity and mortality in the United States. Persons entering drug abuse treatment smoke at 3-4 times the rate, and staff in publicly funded programs smoke at twice the rate, of the general population. Although the burden of illness and associated economic costs of nicotine addiction are elevated in the drug treatment population, treatment programs rarely address comorbid nicotine addiction.

In this project, we forecast changes in California smoking behavior and health care costs due to state tobacco control policies. The goals of this project include estimating and forecasting changes in statewide California smoking behavior and health care costs. These changes are due to state tobacco control policies and changes in the state cigarette tax and funding for tobacco control education programs.

This is a household survey of young adults in San Francisco and Alameda counties to examine how changes in the current policy context affect tobacco use and other health behaviors. The study includes retail and neighborhood audits.

The purpose of this project was to characterize the San Francisco public’s perceptions and opinions about the ban of tobacco sales in pharmacies. On October 1, 2008, the City and County of San Francisco amended an ordinance of the San Francisco Health Code, prohibiting the sale of tobacco products in San Francisco pharmacies. “Big Box” stores (such as Costco) and grocery stores (such as Safeway) were not included in the ban. Opponents expressed concern that such a ban would have a negative financial impact on the pharmacies in question, which in San Francisco are primarily Walgreens.

The project examines the exposure to secondhand smoke (SHS) among U.S. adults and children, and quantifies the economic burden of the SHS exposure in terms of healthcare costs and lost productivity from lost time and premature mortality. It also assesses the impact of exposure to SHS on two particularly vulnerable populations – African Americans and Hispanics.

The objective of this study is to examine smoking behavior and estimate the economic burden of smoking among California adults with mental disorders. The proposal seeks to determine: (1) smoking prevalence rates and cigarette consumption per smoker among mentally ill adults, (2) healthcare costs of smoking among mentally ill adults, and (3) value of lost productivity from smoking-related diseases among mentally ill adults.

Most effective tobacco control policy in the United States has been enacted at the local and, more recently, state level. This project uses case study methods to research how the tobacco industry and tobacco control professionals influence state and local policy making to develop knowledge that will lead to more effective tobacco control policies and strategies, while taking into account the major changes and uncertainties in the tobacco control policy environment that continue to occur: Specifically, the project

This project will evaluate what community stakeholders know about a new citywide ordinance that bans smoking in multi-unit housing (MUH) in Richmond, California. In this in-depth case study, we will use focus groups and one-on-one interviews to identify and document successes and challenges of implementing a smoke-free policy in multi-unit housing.

In partnership with one of the largest permanent supportive housing programs for homeless and low-income adults with special needs in San Diego County, we will conduct a pre- and post-policy evaluation a smoke-free policy that includes restrictions on smoking in indoor and shared outdoor areas. The study will examine tobacco use behaviors, exposure to secondhand smoke, knowledge of, adherence to, and attitudes toward the smoke-free policy among the clientele of 4 permanent supportive housing programs.

Healthcare costs play a central role in FDA regulatory impact analysis. Many factors contribute to tobacco- attributable healthcare costs, including changing tobacco product use patterns, sociodemographic characteristics, health status, and socioeconomic status (SES). The central goal of this project is to develop economic models that analyze the impact of new patterns of tobacco product use on healthcare costs for different populations including those that are particularly vulnerable.

This project contains two main components: 1) an analysis of the impact of the California Tobacco Control Program on population prevalence and per capita consumption; and 2) an estimation of the economic impact of changed smoking prevalence on smoking-attributable healthcare costs and mortality costs. These two components will be combined to project the effects of changes in the level of funding of the California Tobacco Control Program on healthcare costs and mortality costs for the next five and ten years.

Analysis of the tobacco industry efforts to interfere with implementation of the WHO FCTC, currently focused on the tobacco industry interference with implementation of the Protocol on the Illicit Trade of Tobacco Products. As part of the WHO Collaborating Center, provision of support and technical assistance to WHO on implementation of Article 5.3 and its guidelines, i.e. establishing measures to protect tobacco control against the tobacco industry interference.

Accurate assessment of the impact of tobacco use on health outcomes and healthcare expenditures is critical in regulatory science to assist policy makers to promulgate rational policies. However, confounding is a potential problem for assessments based on observational studies. Recently, modern analytic methods that use causal modeling have been successfully applied to address confounding inherent in observational research.

Recreational marijuana use has been legalized in 8 states (as of 2017) and medical marijuana is widely legal. The political forces pushing for these changes have come from marijuana enthusiasts and businesses with very little involvement of organizations that prioritize public health. This research is examining this process as well as opportunities to inject a public health perspective into these policy debates.

The goals of this project are to conduct case studies of selected California locales that may be candidates for implementing innovative endgame-furthering policy measures and to analyze tobacco industry documents to describe the industry’s understanding of endgame-oriented measures and its plans and strategies for opposing them.

An important component of any FDA regulation of tobacco products is an economic analysis of the regulation. Models of the health-related economic costs of cigarette smoking have evolved and improved over the years, and current models take into account the complex relationship between smoking, health, and healthcare expenditures. However, there is a lack of research on healthcare costs attributable to the use of tobacco products other than cigarettes. It is important to have this information given the increased rates at which non-cigarette products are being used.

The UCSF Center for Tobacco Control Research and Education is home to one of 14 Tobacco Centers of Regulatory Science (TCORS) funded as part of a first-of-its-kind tobacco science regulatory program by the U.S. Food and Drug Administration and the National Institutes of Health. CTCRE Director Professor Stanton Glantz is Principal Investigator for this 4 year $20 million project.

This project investigates tobacco industry political strategies after the institution of "corporate culture" reforms in the 1998 Master Settlement Agreement. It addresses, in particular, the industry's response to tobacco control activities and the industry's use of outside organizations to advocate for its policy goals.

This project uses tobacco industry documents to explore how the tobacco industry has responded to public health and other campaigns that focus attention on the behaviors of the tobacco industry, and to develop a resource for advocates designing such campaigns.